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Controlled-release opioids and alcohol
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     Interpretation of the article by Sally Murray and Eric Wooltorton1 on alcohol-associated rapid release of a long-acting opioid will be faciliated by the following information: 1. The opioid formulation in question (Palladone XL, once-daily hydromorphone) is not available in Canada. 2. Information on the composition of the capsule shell is not relevant to the effect of alcohol, since control of release of hydromorphone from Palladone XL does not depend on the capsule shell itself. 3. The controlled-release technology employed in Palladone XL is not the same as that of the other controlled-release opioid formulations distributed by Purdue Pharma in Canada. In response to the request from Health Canada, noted in the article, Purdue Pharma recently submitted information for their review, indicating that an effect of alcohol of the type seen with Palladone XL does not occur with MS Contin, Codeine Contin, Hydromorph Contin or OxyContin. 4. Because of the potential for interaction between the pharmacologic effects of alcohol and any CNS depressant drug, such as opioid analgesics, co-ingestion of alcohol and such drugs is never advisable.

    REFERENCE

    Murray S, Wooltorton E. Alcohol-associated rapid release of a long-acting opioid. CMAJ 2005;173(7):756.[Free Full Text](Andrew C. Darke)